HIV, Human Rights and Migration: Narratives of HIV-Positive Asylum Seekers in Scotland

Abstract

Political instability, armed unrest, religious intolerance, human rights violations, ethnic conflict and environmental disasters that threaten one’s life, displace people and often compel them to seek asylum elsewhere. Over the years, the UK has been a major recipient of asylum seekers, some of whom have come to Scotland, especially since 2000, and among these there are a number who present health issues including being HIV-positive. HIV-positive asylum seekers experience poverty, isolation, vulnerability, stigma and discrimination, which when coupled with a lack of appropriate medical care and support, have the potential of adding another layer on the denial of fundamental human rights and further stigmatising people who are already fleeing circumstances threatening their very existence. This paper discusses findings from a recent study that examined the lived experiences of HIV-positive asylum seekers since their arrival in Scotland. A flexible qualitative research design that included in-depth interviews that used life history and a phenomenological approach was adopted. Underpinned by ethics approval, nineteen HIV-positive Black African asylum seekers were recruited through third sector organisations in Glasgow, Scotland. Additional data were gathered from two emotive and discursive focus group meetings. Findings were developed using narrative analysis. The accounts of the asylum seekers reflect continued fear of stigma in the face of HIV disclosure, but also pervasive poverty and inequality. Their experiences include denial of rights to family and security, fear of being detained and deported, denial of appropriate medical care, symptoms of post-traumatic disorder and the culturally insensitive and sometimes inhumane attitude of the UK Immigration Agency. These themes depict an everyday struggle in a context of denial of support and risk of potential deportation to a country where HIV treatment is limited or inaccessible. Their narratives also attest to the life-giving, unstinting care and support they receive from a handful of voluntary agencies and one specialist HIV clinic in Scotland. The findings from this study raise issues for a debate about the treatment of HIV-positive asylum seekers in Scotland. Poverty, inequality, stigma and discrimination continue to pose difficulties in accessing care and treatment and wider community integration. Often treated in a piecemeal and ‘service-siloed’ fashion, the needs and human rights of HIV-positive asylum seekers require a greater, more holistic practice and policy attention.

The place of social work in improving access to health services among refugees: A case study of Nakivale settlement, Uganda

“…Although humanitarian assistance is essential during crises, it may well cause inadvertent harm and increase pain if it is not administered in a sensitive way (Papadopoulos, 2010). Disrespect for refugee women in the NRS is consistent with previous research on other refugee contexts showing a high degree of stigma as well as discriminatory and authoritarian policies against forced migrants (Freedman, 2019; Palattiyil and Sidhva, 2011). Freedman describes the symbolic violence experienced by refugee women arriving in Europe, and particularly those who are easily identified as Muslim.…”

“…This easily fits into experiences of the refugees documented in a large body of literature concerning the poor living conditions of refugees (e.g. Allan, 2014; Palattiyil and Sidhva, 2011; Wachter et al, 2016). Refugees flee to a new country with the expectations of protection and achieving a decent quality of life, but they end up suffering challenges.…”

“…Moving from ‘vulnerability to vulnerability’, as described by Palattiyil and Sidhva (2011: 89), can help us to conceptualise risks that refugees continue to face within the host country. Although it is widely acknowledged that refugees experience extreme difficulties in accessing required services (Stamatel and Zhang, 2018), there is scant information concerning the problems of accessing health services for refugees in low-income countries with minimal social services.…”

Left behind on the path to 90‐90‐90: understanding and responding to HIV among displaced people

“…In transit and post-flight, even in settings where displaced populations are eligible to access healthcare, barriers to testing and diagnosis exist [56] and include a lack of information about where to obtain testing, prioritization of basic needs over health, financial and logistical constraints, difficulty navigating complex administrative processes, language and communication challenges, stigma, concerns about the confidentiality of health information and mistreatment by healthcare providers [29,41,[57][58][59]. On the other hand, when HIV testing is mandatory as part of the resettlement pathway, those with precarious legal status may fear being denied a visa or deported if diagnosed with HIV [60,61]. Populations in transit and those in situations of ongoing instability may also be impacted by attacks on healthcare workers and health facilities which hinder service provision and deter healthcare seeking [62].…”

Gendered dimensions of health in refugee situations: An examination of sexual and gender-based violence faced by refugee women in Nakivale refugee settlement, Uganda

“…Women form a large proportion of the refugee population worldwide (World Bank, 2019). The interconnections between gender, forced migrations and violence have been commented on in the large body of literature (Alsaba and Kapilashrami, 2016; Crawford et al, 2017; Fassetta et al, 2016; Fassetta and Quinn, 2018; Freedman, 2019; Fry et al, 2019; Manandhar et al, 2018; Palattiyil and Sidhva, 2011). Gender represents existing relations and expectations among people and reflects the distribution of power within those relationships (Manandhar et al, 2018).…”